Etiological Analysis Of Hematoma Enlargement In Spontaneous Intracerebral Hemorrhage

Objective 1.The clinical characteristics and laboratory examinations of patients with spontaneous intracerebral hemorrhage in our hospital were analyzed,and the risk factors causing hematoma expansion were explored.2.Based on the imaging features of plain scan CT,the ability of swirl sign,blend sign,black hole sign and island sign to identify early HE was compared and analyzed.Methods The clinical data of 209 patients with sICH who were hospitalized in the Hospital of Ningxia Medical University from May 2017 to April 2019 were retrospectively analyzed.The hematoma volume of sICH patients was calculated using the Tada formula.The hematoma volume within 6 hours after onset and the hematoma volume reviewed within 24 hours after the first CT examination were calculated.The patients were divided into HE group and non-HE group based on whether the hematoma volume exceeded 6 ml.The risk factors affecting HE were compared between groups,and the independent risk factors affecting HE were analyzed by multivariate regression.Based on the plain CT scan,compare and analyze whether swirl sign,blend sign,black hole sign and island sign can predict the early HE,draw ROC curve and use the area under the curve(AUC)to evaluate the authenticity and accuracy of these four image signs in the early prediction of HE,and to assess their predictive value.Results Of the 209 sICH patients,68 had early hematoma enlargement.Analysis of risk factors resulted in: there was no significant difference(p> 0.05)in comparison age,gender,history of drinking,smoking history,hypertension,diabetes,history of cerebrovascular disease,systolic blood pressure at admission,hyperhomocysteinemia,hyperlipidemia,and whether the bleeding broke into the ventricular system.The bleeding site,the amount of first bleeding,and the level of GCS were related to the early hematoma enlargement,and there were significant statistical differences between the two groups(P<0.001).However,through Logistic multivariate analysis,it was found that GCS is a risk factor affecting HE.The analysis based on the NCCT image signs showed that swirl sign,blend sign,black hole sign,and the island sign were related to early HE through group comparison,and the differences were statistically significant(P<0.001).After correcting the confounding variables,through multi-factor logistic regression analysis,it was concluded that the blend sign,black hole sign,and island sign could predict the early HE independently.Swirl signs cannot be predicted independently.The area under the curve(AUC)of the three independent predictive HE image markers of blend sign,black hole sign and island sign were 0.569,0.533,and 0.655,respectively.Conclusions 1.The glasgow coma score was a risk factor for early HE.2.Blend sign,black hole signand island sign can independently predict early HE,and they are reliable image signs for predicting early HE.